Mesh fixation compared with nonfixation in transabdominal preperitoneal laparoscopic inguinal hernia repair

This study was conducted to compare laparoscopic inguinal hernia repair with or without mesh fixation regarding recurrence rate and duration of operation time. A sample of 73 patients who underwent laparoscopic transabdominal pre-peritoneal (TAPP) inguinal hernia repair from January 2002 to January 2010 were derived from the medical records of university hospitals including Ekbatan, Beasat, and Shaheed Beheshti, as well as private hospitals. MERSILENE™ Mesh (Johnson & Johnson Medical GmbH, Norderstedt, Germany) fixation was performed for 23 cases and polypropylene mesh without fixation for the rest. The recurrence rate was followed in both groups for two years. The patients ages were from 7 to 64 years, 70 patients (95%) were male. Operation time for mesh fixation and nonfixation was 68.09 and 21.10 minutes, respectively (P < 0.001). Two recurrences occurred in the mesh fixation group versus no recurrence in the nonfixation group (P = 0.096). The results of this study revealed that laparoscopic TAPP inguinal hernia repair without mesh fixation is safe and feasible with no increase in recurrence rate. In addition, it offers a significantly shorter operation time than TAPP mesh fixation. However, we need more evidence based on randomized clinical trials to compare the benefits and harm of the two methods.